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Individual

MARY ELLEN PIZZA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2121 HUGHES DR, SUITE 300, TOLEDO, OH 43606-3845
(419) 291-2121
(419) 479-6017
Mailing address
2121 HUGHES DR, SUITE 300, TOLEDO, OH 43606-3845
(419) 291-2121
(419) 479-6017

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35067177
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000141209
ANTHEM
OH
01
000000270707
ANTHEM
MI
01
0105559
BCMH
OH
05
0105559
OH
01
01873
PHC
OH
01
063626
AETNA
OH
01
10725
HPM
OH
01
12-01242
UHC
OH
01
12-03671
UHC
MI
01
3505802311
BCBS MI
MI
01
4519541
AETNA
MI
Enumeration date
08/25/2005
Last updated
07/08/2007
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